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Goals-of-care decision in the ED — RCPSC EM MCQ

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HardEthics, medicolegal, Indigenous healthGoals-of-care decision in the EDRCPSC EM

A 76-year-old woman with advanced dementia is transferred from long-term care for pneumonia, hypoxia and sepsis. She has a valid provincial goals-of-care form requesting comfort-focused care and no hospital admission. Her substitute decision-maker agrees this reflects her values. What is the most appropriate disposition?

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Correct answer: D — Return to long-term care or hospice-level setting with comfort-focused treatment if symptoms can be managed safely

When valid advance care planning and substitute decision-making are aligned, ED disposition should honour the patient's goals while ensuring symptom control, communication and safe care arrangements.

Reference: CanMEDS Professional role; Canadian medicolegal consent principles